Aim: To evaluate the frequency of incus bone erosion during mastoid exploration in chronic suppurative otitis media with cholesteatoma of the middle ear. Study design: A cross-sectional descriptive study. Place and duration: In the ENT Department of Services Hospital Lahore for the one-year duration from January 2018 to January 2019. Methods: 70 chronic suppurative otitis media patients with the middle ear cholesteatoma were prospectively evaluated and selected with a non-probability purposive sampling technique. The operation was performed on 70 patients under general anaesthesia in the operating room. A standard questionnaire was prepared and history, examination, laboratory data, and treatment were recorded for each patient. Results: One of the usual common diseases of the ear, nose and throat is chronic suppurative otitis media. Previously this disease was called atticoantral type was considered usually unsafe, is mostly caused by marginal perforation with cholesteatoma, the distinguishing feature of this condition and is taken as a complicating element. A total of 70 patients with chronic suppurative otitis media with middle ear cholesteatoma were included in the study. Forty-five (64.28%) are men and 25 (35.71%) are women. 2: 1 was the M: F ratio. There were 10 patients in the first age group from 1 to 10 years 10 (14.28%), in the second age group patients from 11 to 20 years 35 (50%), in the third age group 21-30 years 12 (17.14%), in the fourth age group, 31 to 40 years of age 5 (7.14%), in the fifth age group, 41 to 50 years age 5 (7.14%), and in the sixth age group, 3 patients were >50 years (4.28%). The mean ± standard deviation in the age group was 21.2 ± 11.9 years. The mastoidectomy was performed in 64 patients (91.42%) and a modified radical mastoidectomy was performed in 6 patients (8.57%). Bone erosion due to suppurative otitis media with middle ear cholesteatoma was absent in 59 patients (84.28%) and 11 patients (15.71%) without bone erosion.